Circumferential spinal cord decompression through a single posterior approach with microendoscopy for thoracic and thoracolumbar ossification of the posterior longitudinal ligament

Thoracic and thoracolumbar ossification of the posterior longitudinal ligament (OPLL) can be difficult to treat due to the anatomical position. The purpose of this study was to report the significance of a novel surgical technique that represented two cases of thoracic or thoracolumbar OPLL. The first patient was a 72-year-old woman who had a beak-type OPLL at the T11/12. The second was a 45-year-old woman who had a beak-type OPLL at the T12/L1. We performed circumferential spinal cord decompression through a single posterior approach with microendoscopy in both cases. The postoperative computed tomography revealed the complete removal of the OPLL, and the magnetic resonance imaging confirmed adequate decompression of the spinal cord. Preoperative symptoms were substantially improved in both patients. To date, we have used this novel technique to treat five patients with thoracic or thoracolumbar OPLL. This new surgical technique is likely to be useful in patients with a beak-type OPLL of the thoracic or thoracolumbar spine.